KMU Past Paper Practice

Question:

A 56-year-old man with a malignant lymphoma receives a cytotoxic drug that can damage malignant cells even when they are not passing through one particular phase of the cell cycle. Which pharmacological category best describes this drug?

Options:

Correct Answer: Cell cycle-nonspecific cytotoxic

Explanation: Cell cycle-nonspecific agents can injure malignant cells during several phases rather than requiring entry into one specific phase.

Question:

A 63-year-old patient with malignancy is being considered for methotrexate therapy. Laboratory evaluation shows markedly impaired renal function. Which factor most strongly increases the risk of excessive methotrexate toxicity in this patient?

Options:

Correct Answer: Impaired renal elimination of the drug

Explanation: Significant renal impairment reduces methotrexate clearance, increasing systemic exposure and the risk of serious toxicity.

Question:

Azathioprine enters a cell and is converted to metabolites related to 6-mercaptopurine. Which biochemical process is subsequently inhibited to produce its antiproliferative effect?

Options:

Correct Answer: De novo purine nucleotide synthesis

Explanation: Azathioprine is converted to 6-mercaptopurine-related metabolites that interfere with purine synthesis and thereby reduce nucleic acid production.

Question:

A patient receiving azathioprine develops progressive fatigue. Investigations show leukopenia together with elevated hepatic enzymes. Which adverse-effect pattern best fits the responsible drug?

Options:

Correct Answer: Myelosuppression with hepatotoxicity

Explanation: Bone marrow suppression and hepatic injury are important toxicities of azathioprine and explain the leukopenia and raised liver enzymes.

Question:

During a pharmacology discussion, students are asked to identify two anticancer agents originally obtained from the Madagascar periwinkle, Catharanthus roseus. Which pair is correct?

Options:

Correct Answer: Vincristine and vinblastine

Explanation: Vincristine and vinblastine are vinca alkaloids originally derived from the Madagascar periwinkle.

Question:

A 5-year-old child with Wilms tumor receives an antitumor antibiotic. The drug binds between DNA base pairs and markedly interferes with transcription. Which mechanism best describes its action?

Options:

Correct Answer: DNA intercalation with inhibition of RNA synthesis

Explanation: Dactinomycin intercalates into DNA and interferes with transcription, thereby suppressing RNA synthesis in rapidly proliferating cells.

Question:

A 4-year-old child undergoes surgery for a renal malignancy and is subsequently started on chemotherapy. Histology confirms Wilms tumor. Which antitumor antibiotic has an established role in this disease?

Options:

Correct Answer: Dactinomycin

Explanation: Dactinomycin is an antitumor antibiotic with an important role in treatment regimens for Wilms tumor.

Question:

An anticancer antibiotic is most active during the G2 phase and damages malignant-cell DNA by generating free radicals that produce strand breaks. Which drug has this pharmacological profile?

Options:

Correct Answer: Bleomycin

Explanation: Bleomycin produces free-radical-mediated DNA strand breaks and has greatest cell-cycle activity in the G2 phase.

Question:

A woman with a hormone-dependent breast malignancy is treated with aminoglutethimide. Which change contributes most directly to its anticancer effect?

Options:

Correct Answer: Reduced steroid and estrogen synthesis

Explanation: Aminoglutethimide inhibits steroid-hormone synthesis and aromatase-mediated estrogen formation, reducing hormonal stimulation of susceptible tumors.

Question:

A 22-year-old patient is newly diagnosed with acute leukemia. Intensive systemic chemotherapy is started with the immediate objective of achieving the first complete remission. Which treatment modality is being used?

Options:

Correct Answer: Primary induction chemotherapy

Explanation: Induction chemotherapy is the initial intensive treatment used to produce remission, particularly in acute leukemias.

Question:

A 50-year-old woman undergoes complete surgical removal of a breast carcinoma. Systemic chemotherapy is then prescribed despite no visible residual tumor, with the aim of destroying microscopic malignant cells that may remain. Which treatment strategy is this?

Options:

Correct Answer: Adjuvant chemotherapy

Explanation: Adjuvant chemotherapy is given after definitive local treatment to eradicate microscopic residual disease and reduce recurrence.

Question:

A child with newly diagnosed acute lymphoblastic leukemia is started on induction therapy that includes a corticosteroid and a vinca alkaloid. Which drug from this class is characteristically included?

Options:

Correct Answer: Vincristine

Explanation: Vincristine is an important component of classic ALL induction combinations together with a corticosteroid and other antileukemic agents.

Question:

A 45-year-old man with acute myeloid leukemia is planned for induction chemotherapy with cytarabine plus an anthracycline. Which drug best completes this classic combination?

Options:

Correct Answer: Daunorubicin

Explanation: A classic AML induction approach combines cytarabine with an anthracycline such as daunorubicin.

Question:

An elderly patient with chronic lymphocytic leukemia requires conventional cytotoxic treatment. Which alkylating agent has a classic association with treatment of this disease in undergraduate pharmacology?

Options:

Correct Answer: Chlorambucil

Explanation: Chlorambucil is a classic conventional alkylating drug associated with treatment of chronic lymphocytic leukemia.

Question:

A 39-year-old patient is diagnosed with chronic myeloid leukemia. Molecular testing demonstrates the characteristic BCR-ABL abnormality. Which drug is classically associated with targeted treatment of this disease?

Options:

Correct Answer: Imatinib

Explanation: Imatinib is the classic targeted drug associated with BCR-ABL-positive CML and is a high-yield disease–drug association.

Question:

A 28-year-old patient with Hodgkin lymphoma is planned for a classic four-drug combination. Which set correctly represents the ABVD regimen?

Options:

Correct Answer: Doxorubicin, bleomycin, vinblastine, dacarbazine

Explanation: ABVD consists of doxorubicin, bleomycin, vinblastine and dacarbazine and is a classic Hodgkin lymphoma regimen.

Question:

A patient with non-Hodgkin lymphoma receives cyclophosphamide, doxorubicin, a vinca alkaloid and prednisolone. Which vinca alkaloid forms part of this classic CHOP combination?

Options:

Correct Answer: Vincristine

Explanation: CHOP contains cyclophosphamide, doxorubicin, vincristine and prednisolone; vinblastine is used in ABVD instead.

Question:

A 62-year-old man with carcinoma lung is being considered for conventional combination chemotherapy. The treating team plans a platinum-based regimen. Which drug best fits this treatment principle?

Options:

Correct Answer: Cisplatin

Explanation: Cisplatin is an important platinum compound used as a conventional chemotherapy component in several solid tumors, including lung carcinoma.

Question:

A 58-year-old patient with carcinoma stomach is started on conventional systemic treatment containing a fluoropyrimidine. Which anticancer agent belongs to this group and has an established role in gastric malignancy?

Options:

Correct Answer: 5-Fluorouracil

Explanation: 5-Fluorouracil is a fluoropyrimidine antimetabolite and is an important conventional component of chemotherapy for gastric carcinoma.

Question:

A cancer survivor develops a second malignancy several years after receiving DNA-damaging cytotoxic chemotherapy. Which general property of conventional anticancer drugs best explains this delayed complication?

Options:

Correct Answer: Mutagenic injury to normal DNA

Explanation: DNA-damaging cytotoxic drugs can produce mutations in surviving normal cells, creating a long-term risk of secondary malignancy.